Wu Zhi-yong, Mao Zhi-fu, Gao Shang-zhi, Cheng Bang-chang, Wang Zhi-wei, Huang Jie
Department of Cardiothoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Zhonghua Wai Ke Za Zhi. 2006 Jul 15;44(14):943-5.
To analyze the factors which influence the safety and prognosis of aorta replacement combined with coronary artery bypass grafting (CABG) for thoracic aortic aneurysm associated with coronary artery disease.
From May 1982 to October 2002, 67 patients with thoracic aortic aneurysm were admitted, and 24 of them combined with CABG. Of the 24 patients, 9 received descending aorta replacement combined with CABG, and the other 15 received the ascending aorta replacement combined with CABG. The treatment results were compared with the other 43 patients only undergoing the thoracic aortic replacement.
The mortality rate of the patients with aorta replacement combined with CABG was 13% (3/24). Though the descending aorta replacement combined with CABG could make the cardiopulmonary bypass time and selective cerebral perfusion time longer, (278 +/- 54) min and (188 +/- 59) min respectively, no significant difference was observed in postoperative complications, 3-year survival rate, 3-year-cardiac-event-free rate compared with the patients only undergoing the thoracic aortic replacement (P > 0.05).
The aorta replacement combined with CABG can be performed safely, and the revascularization for coronary artery disease is useful for preventing occurrence of cardiac events.
分析影响合并冠心病的胸主动脉瘤患者行主动脉置换联合冠状动脉旁路移植术（CABG）安全性及预后的因素。
1982年5月至2002年10月收治67例胸主动脉瘤患者，其中24例合并CABG。24例患者中，9例行降主动脉置换联合CABG，另外15例行升主动脉置换联合CABG。将治疗结果与另外43例仅行胸主动脉置换的患者进行比较。
主动脉置换联合CABG患者的死亡率为13%（3/24）。尽管降主动脉置换联合CABG会使体外循环时间和选择性脑灌注时间延长，分别为（278±54）分钟和（188±59）分钟，但与仅行胸主动脉置换的患者相比，术后并发症、3年生存率、3年无心脏事件发生率差异均无统计学意义（P>0.05）。
主动脉置换联合CABG可安全进行，冠心病血运重建有助于预防心脏事件的发生。
